AccountId: 011433970860
ContactId: 50be9c87-4a88-4818-b6c9-1534413fc43d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 204600 ms
Total Talk Time (AGENT): 67154 ms
Total Talk Time (CUSTOMER): 129726 ms
Interruptions: 3
Overall Sentiment: AGENT=1.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/50be9c87-4a88-4818-b6c9-1534413fc43d_20250423T17:33_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I'm your check with the claims.
[AGENT][NEUTRAL] OK, I could check on a claim for you. um, I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] My name is [PII]. It is [PII]
[AGENT][NEUTRAL] OK, I mean, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, uh, the callback number is [PII].
[AGENT][NEUTRAL] Thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Yes, uh, the policy number is 01941620.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Patient name is uh [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. uh, what was the date of service for this client?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] It is uh [PII] and the bill amount is $105 even.
[AGENT][POSITIVE] OK, got it, thank you one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] You you.
[CUSTOMER][NEUTRAL] Does.
[AGENT][NEUTRAL] What was the name of the provider's office this was with Irene?
[CUSTOMER][NEUTRAL] It is Southern California Permanente Medical Group.
[AGENT][POSITIVE] OK, thank you for verifying that one moment.
[CUSTOMER][NEUTRAL] you
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It.
[AGENT][NEUTRAL] OK, so we did receive this claim, uh, we were unable to pay a benefit as charges incurred in an independent lab are not covered under this policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Uh, service render in independent lab is not covered.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, so it is not covered under the patient plan or provider?
[AGENT][NEUTRAL] Under this patient's plan.
[CUSTOMER][NEUTRAL] Children. OK. And what is the patient plan to get a more PPO?
[AGENT][NEUTRAL] Uh, it's neither, um, it is a secondary medical policy that is designed to help with co-pay, deductible and co-insurance after major medical pays.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] And uh
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So it is one moment, so you say the client was ordinary service rendered by independent lab is not covered.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And can I have your reference.
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date. So my name is spelled [PII] Last [PII], was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] No, and thank you for assisting today and have a great day. Bye.
[AGENT][POSITIVE] Of course, thanks for calling APL you too bye bye.
[CUSTOMER][NEUTRAL] Mhm.